Objective. Elevated plasma homocysteine (Hcy) is an independent risk factor for cardiovascular diseases, but the precise mechanism of Hcy in cardiovascular disease remains elusive. This study is aimed at evaluating the association between Hcy levels and autonomic nervous system and at investigating their clinical relevance in obstructive sleep apnea syndrome (OSAS). Methods. A total of 191 subjects with OSAS were enrolled for this cross-sectional study. Heart rate variability (HRV) represents the status of the autonomic nervous system and is a well-known index that allows studying the autonomic modulation. HRV and polysomnography parameters were collected based on Holter monitors and polysomnography system. The software computed all the basic HRV parameters including SDANN, SDNN and pNN50. Correlation analyses between Hcy and HRV parameters and echocardiographic parameters were performed. Results. Compared with the mild-moderate OSAS group, the prevalence of male and smoking and Hcy levels were considerably higher in the severe OSAS group (, , and , respectively). Also, there were significant linear relationships between Hcy quartiles with the proportion of severe OSAS ( for the trend). Interesting, there is a negative linear correlation between SDANN and Hcy quartiles ( for the trend). Spearman’s correlation analysis showed a significant negative correlation between SDANN and Hcy levels (, ). Interestingly, the relationship of it remains significant after adjustment for clinical covariates (, ). However, echocardiographic parameters were not significantly correlated with Hcy or HRV parameters (all ). Conclusions. Elevated plasma Hcy level is linearly correlated with cardiac autonomic nervous function disorders in patients with OSAS.

中文翻译：

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血浆同型半胱氨酸和自主神经功能障碍：OSAS 的关联和临床相关性。

客观。血浆同型半胱氨酸（Hcy）升高是心血管疾病的独立危险因素，但Hcy在心血管疾病中的确切机制仍然难以捉摸。本研究旨在评估 Hcy 水平与自主神经系统之间的关联，并探讨其在阻塞性睡眠呼吸暂停综合征 (OSAS) 中的临床相关性。方法. 共有 191 名患有 OSAS 的受试者参加了这项横断面研究。心率变异性 (HRV) 代表自主神经系统的状态，是一个众所周知的指标，可以研究自主神经调节。HRV和多导睡眠图参数是基于Holter监测器和多导睡眠图系统收集的。该软件计算了所有基本 HRV 参数，包括 SDANN、SDNN 和 pNN50。进行了 Hcy 和 HRV 参数与超声心动图参数之间的相关性分析。结果。与轻中度 OSAS 组相比，重度 OSAS 组的男性患病率和吸烟率及 Hcy 水平显着升高。, ,和，分别）。此外，Hcy 四分位数与严重 OSAS 的比例之间存在显着的线性关系（为趋势）。有趣的是，SDANN 和 Hcy 四分位数之间存在负线性相关（为趋势）。Spearman 的相关分析显示 SDANN 和 Hcy 水平呈显着负相关（, ）。有趣的是，在调整临床协变量后，它的关系仍然显着（, ）。然而，超声心动图参数与 Hcy 或 HRV 参数没有显着相关性（所有）。 结论。升高的血浆 Hcy 水平与 OSAS 患者的心脏自主神经功能障碍呈线性相关。